| NPI | 1790051738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERCY ANDERSON CEO/Owner 601-502-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: MS 80107) |
| Additional Taxonomies | 213ES0000X Podiatrist, Sports Medicine (Licence: MS 80107) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2012-03-23 |